VIRUSMYTH HOMEPAGE

Science 267:159
Jan. 13, 1995

The Duesberg Phenonemon: What does it mean?

Robert S. Root-Bernstein

Thank you for identifying me as a Duesberg critic. I worry, however, that many investigators will misinterpret my position. The question is not "HIV or not HIV?" It is whether HIV is both necessary and sufficient to cause AIDS. While the studies cited by Cohen address the question of necessity, none addresses the issue of sufficiency. At least four other well­established infectious disease models exist besides unifactorial causation: synergistic, multifactorial or multistep progression, opportunistic, and autoimmune (1, 2). None of these has been adequately tested. The issue of Koch's postulates is critical. Diseases that are not unifactorial must satisfy criteria other than Koch's. For example, in 1930, Shope demonstrated that swine flu in pigs is synergistic, requiring both a virus and a bacterium, and could not be induced by either one alone in any dose (3). Autoimmune diseases must also satisfy different causative criteria (2, 4). Thus, HIV may be 100% correlated with AIDS, it may be necessary for disease induction; but it still might not be sufficient We cannot know until we do the appropriate tests. The fact that HIV is remaining within high­risk groups characterized by immunosuppressive risks (for example, disease, drugs, malnutrition, and blood products) argues in favor of performing such tests.

In this context, the three "risk­free" AIDS cases among laboratory workers that are supposed to prove HIV causation become problematic. What Anthony Fauci, Robert Gallo, William Blattner, and others appear to mean by "risk­free" is that no source of HIV other than occupational exposure has been identified. I accept the source of the HIV infection, but mean something different by "risk­free": I mean, free of non­HIV immunosuppressive risks. Proof is needed that the patients were, in accordance with Koch's postulates, also (i) immunologically healthy at the time of HIV exposure [meaning free of immunomodulatory factors, for example, active hepatitis, cytomegalovirus, Epstein­Barr virus; nonintravenous drug use; autoimmune conditions; malnutrition; infections requiring antibiotic use; and so forth (1, 2)] and (ii) free of coinfection with suspected AIDS cofactors such as mycoplasmas, viruses, or human leukemia cells that are universally present with HIV in laboratory situations (2, 4).

Indeed, Cohen's articles do not mention idiopathic CD4­T cell lymphopenia (ICL)-cases that match the clinical description of AIDS but lack all sign of HIV infection. If three cases of "risk­free" HIV infection "prove" causation, then the more than 100 ICL cases "disprove" it. Logically, of course, neither conclusion follows. What we must focus on are the more than 500,000 AIDS cases in North America and Europe in which HIV is accompanied by exposure to cofactors (and the universality of such cofactors in sub­Saharan Africa and Asia). There lies the clue to understanding AIDS, and through intervention with these cofactors, an alternative mode of preventing and treating AIDS.

Robert S. Root­Bernstein
Department of Physiology, Michigan State University, East Lansing, MI 48824, USA

References

1. J. A. Sonnabend, S. S. Witkin, D. I. Portillo, Ann. N.Y Acad. Sci. 837, 177 (1984): in AIDS and Opportunistic Infections of Homosexual Men, P. Ma and D. Armstrong, Eds. (Butterworth, Stoneharn, MA 1989), pp. 449­470; R. S. Root­Bernstein, Res. Immunol. 141, 815 (1990); L. Montagnier et al., C. R. Acad Sci. Paris 311, 425 (1990); S.­C. Lo et at, Science 251, 1074 (1991); J. W. Limefield, Clin. Immunol. Immunopathol. 65, 85 (1992).

2. R. S. Root­Bernstein, Rethinking AIDS {Free Press, New York, 1993).

3. R. E. Shone, J. Exp. Med. 54, 373 (1931); M. Degre and L. A. Glasgow, J Infect Dis. 118, 449 (1968); S. I. Gorbach and J. G. Bartlett, N. Engl. J. Med. 290, 1289 (1 974).

4. E. Wnebsky, N. R. Rose, K Terplan, J. R. Pain, R. W. Egan, J. Am. Med. Assoc. 164,1439 (1957); R. S. Root­Bernstein, in Organism and the font of Self, A. I. Tauber, Ed. (Kluwer, Needham, MA 1991), pp. 159­209.

VIRUSMYTH HOMEPAGE